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Predictive Value of Age- and Sex-Specific Nomograms of Global Plaque Burden on Coronary Computed Tomography Angiography for Major Cardiac Events

2017-03Journal article Open access
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dc.contributor.authorNaoum, C
dc.contributor.authorBerman, D
dc.contributor.authorAhmadi, A
dc.contributor.authorBlanke, P
dc.contributor.authorGransar, H
dc.contributor.authorNarula, J
dc.contributor.authorShaw, LJ
dc.contributor.authorKritharides, L
dc.contributor.authorAchenbach, S
dc.contributor.authorAl-Mallah, M
dc.contributor.authorAndreini, D
dc.contributor.authorBudoff, MJ
dc.contributor.authorCademartiri, F
dc.contributor.authorCallister, TQ
dc.contributor.authorChang, HJ
dc.contributor.authorChinnaiyan, K
dc.contributor.authorChow, B
dc.contributor.authorCury, R
dc.contributor.authorDeLago, A
dc.contributor.authorDunning, A
dc.contributor.authorFeuchtner, G
dc.contributor.authorHadamitzky, M
dc.contributor.authorHausleiter, J
dc.contributor.authorKaufmann, PA
dc.contributor.authorKim, YJ
dc.contributor.authorMaffei, E
dc.contributor.authorMarquez, H
dc.contributor.authorPontone, G
dc.contributor.authorRaff, G
dc.contributor.authorRubinshtein, R
dc.contributor.authorVillines, TC
dc.contributor.authorMin, J
dc.contributor.authorLeipsic, J
dc.date.accessioned2021-04-13T16:00:15Z
dc.date.available2021-04-13T16:00:15Z
dc.date.issued2017-03
dc.description.abstractBackground: Age-adjusted coronary artery disease (CAD) burden identified on coronary computed tomography angiography predicts major adverse cardiovascular event (MACE) risk; however, it seldom contributes to clinical decision making because of a lack of nomographic data. We aimed to develop clinically pragmatic age- and sex-specific nomograms of CAD burden using coronary computed tomography angiography and to validate their prognostic use. Methods and results: Patients prospectively enrolled in phase I of the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes) were included (derivation cohort: n=21,132; 46% female) to develop CAD nomograms based on age-sex percentiles of segment involvement score (SIS) at each year of life (40-79 years). The relationship between SIS age-sex percentiles (SIS%) and MACE (all-cause death, myocardial infarction, unstable angina, and late revascularization) was tested in a nonoverlapping validation cohort (phase II, CONFIRM registry; n=3030, 44% female) by stratifying patients into 3 SIS% groups (≤50th, 51-75th, and >75th) and comparing annualized MACE rates and time to MACE using multivariable Cox proportional hazards models adjusting for Framingham risk and chest pain typicality. Age-sex percentiles were well fitted to second-order polynomial curves (men: R2=0.86±0.12; women: R2=0.86±0.14). Using the nomograms, there were 1576, 965, and 489 patients, respectively, in the ≤50th, 51-75th, and >75th SIS% groups. Annualized event rates were higher among patients with greater CAD burden (2.1% [95% confidence interval: 1.7%-2.7%], 3.9% [95% confidence interval: 3.0%-5.1%], and 7.2% [95% confidence interval: 5.4%-9.6%] in ≤50th, 51-75th, and >75th SIS% groups, respectively; P<0.001). Adjusted MACE risk was significantly increased among patients in SIS% groups above the median compared with patients below the median (hazard ratio [95% confidence interval]: 1.9 [1.3-2.8] for 51-75th SIS% group and 3.4 [2.3-5.0] for >75th SIS% group; P<0.01 for both). Conclusions: We have developed clinically pragmatic age- and sex-specific nomograms of CAD prevalence using coronary computed tomography angiography findings. Global plaque burden measured using SIS% is predictive of cardiac events independent of traditional risk assessment.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCirc Cardiovasc Imaging. 2017 Mar;10(3):e004896.pt_PT
dc.identifier.doi10.1161/CIRCIMAGING.116.004896pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3642
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAmerican Heart Associationpt_PT
dc.subjectAdultpt_PT
dc.subjectAge Factorspt_PT
dc.subjectAgedpt_PT
dc.subjectCanadapt_PT
dc.subjectCoronary Angiographypt_PT
dc.subjectCoronary Artery Diseasept_PT
dc.subjectCoronary Vesselspt_PT
dc.subjectEuropept_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectPredictive Value of Testspt_PT
dc.subjectPrevalencept_PT
dc.subjectPrognosispt_PT
dc.subjectProspective Studiespt_PT
dc.subjectRegistriespt_PT
dc.subjectReproducibility of Resultspt_PT
dc.subjectRepublic of Koreapt_PT
dc.subjectRisk Factorspt_PT
dc.subjectSeverity of Illness Indexpt_PT
dc.subjectSex Factorspt_PT
dc.subjectUnited Statespt_PT
dc.subjectComputed Tomography Angiographypt_PT
dc.subjectMultidetector Computed Tomographypt_PT
dc.subjectNomogramspt_PT
dc.subjectPlaque, Atheroscleroticpt_PT
dc.subjectHCC CIRpt_PT
dc.titlePredictive Value of Age- and Sex-Specific Nomograms of Global Plaque Burden on Coronary Computed Tomography Angiography for Major Cardiac Eventspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue3pt_PT
oaire.citation.titleCirculation. Cardiovascular Imagingpt_PT
oaire.citation.volume10pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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